When it comes to speaking out for the clinical importance of touch, best-selling author Deepak Chopra, M.D. has few peers. He is one of a handful of medical doctors in America who regularly employ massage therapists (15) at his Chopra Center for Well Being.

Established in 1996, his La Jolla, California, center is a blend of East and West, alternative medicine and allopathic medicine, community center and day spa. It is also headquarters for his expanding program of educational workshops for the public and his professional seminars for health professionals.

He continues to write (Ageless Body, Timeless Mind has sold more than a million in hardcover; his latest book, The Path to Love, is his nineteenth) and to fly around the world for speaking engagements. Serving as CEO and education director of the Chopra Center seems to fit nicely into this mix and he also finds time to edit an eight-page monthly newsletter, Infinite Possibilities.

While he is tightly scheduled, he is not tightly wound. He is calm and present, the essence of what he recommends to his worldwide audience. He is gentle, attentive, and relational in demeanor, almost courtly in an old-world way. He wears a double-breasted dark suit with red tie, rather formal when compared to other leading integrative physicians such as Dr. Andrew Weil in his khakis and sweater [see MTJ, Winter 1997] or Jim Gordon in his Levis and sport coat. Shortish Dr. Chopra wears business attire easily in La Jolla, which remains the kind of Southern California old-money enclave where a doctor in a fine suit of clothes still is in place. He doesn’t seem to have much taste or time for the fame-and-fortune lifestyle. He clearly seems to prefer the company of family, friends, and patients. In a recent issue of his newsletter he recounted how his annual holiday with family was a visit to Fatima and other holy sites and that his "life’s purpose now is to serve and to heal and to transform and to love."

For a person sometimes given, in books and lectures, to categorical titles such as "The Seven Spiritual Laws of Success" or "The Seven Essential Steps to Conflict Resolution," in conversation Dr. Chopra is thoughtful and open-minded. His statements normally are preceded by phrases such as, "I think" and he is given to qualifying phases such as "in a sense."

If he is conservative in appearance and demeanor, Dr. Chopra is ever radical in his thinking, including his thinking about massage. His view of medicine and massage in the Western tradition, unique and radical as it is, is enhanced by his celebrity as an author and speaker on human potentials and possibilities. Thus he straddles both Eastern and Western perspectives. In terms of the Eastern traditions, he seems to have almost single-handedly put Ayurvedic medicine, including Ayurvedic massage, on the U.S. map of alternative treatments. His written and spoken body of work is replete with references to the wisdom of this ancient medical tradition from India and his center features its own distinctive signature Ayurvedic massage treatments.

While Dr. Chopra does not practice medicine in the conventional sense and holds no faculty appointments, he was trained in Western allopathic medicine with a specialty in endocrinology. Born in New Delhi, the son of a prominent cardiologist, he attended the All India Institute of Medical Sciences, then came to the U.S. for joint residencies in internal medicine and cardiology. He was, at 35 years of age, appointed chief of staff of the Boston Regional Medical Center. He also taught at Tufts University and Boston University schools of medicine before beginning his exploration of Ayurvedic medicine in the 1980s. This seems to have been triggered by his fascination, then involvement with the Marharishi Transcendental Meditation movement in the U.S.

View of Massage

Dr. Chopra views massage in terms of mind-body medicine, not as a part of physical medicine. This is a far leap from conventional thinking. Dr. Chopra explains the difference between physical therapy and massage therapy this way: "They are two completely different things. Physical therapy’s purpose is to restore neuromuscular functioning after some damage, whereas massage therapy has systemic effects. It influences your immune system, your endocrine system, your cardiovascular system." In Dr. Chopra’s view, this is a distinction that a physician should be able to make readily.

When he speaks of massage having "systemic effects," Dr. Chopra draws on his background in endocrinology and the work of researchers such as neuroscientist Candace Pert and psychologist Tiffany Field who chart the effects of touch through biochemical changes in the brain and body. In the terms of his eastern vocabulary, touch is stimulating the Marma points, the junction points between physiology and consciousness in Ayurveda. In his Western vocabulary, touch is the sensory experience which gives rise to emotions and higher levels of consciousness. It’s about consciousness as well as soft tissue. Regarding what physicians need to know about massage therapy, Dr. Chopra says, "The first and most important thing is that it works," that they should recommend it to their patients. The questions he gets from doctors in Europe are "more sophisticated" than those he gets from American doctors: "In Europe, physicians are much more open because alternative and complementary medicine, including homeopathy and Ayurveda, have a much longer tradition in those countries."

He has specific thoughts about what physicians should do to begin integrating massage into their medical practices. He warns that "They can’t do it all by themselves. They have to start now, looking at offering these services in their offices, using massage therapists and meditation instructors."

He has already done this at the Chopra Center. Besides the fifteen massage therapists, the center employs specialists who teach meditation, breathing techniques, and yoga in regularly scheduled sessions. On the shared benefits of these disciplines Dr. Chopra says, although each "acts at different levels, they are, in a sense, synchronistic in their effects."

He also has a suggestion, taken from his personal experience, for ways that doctors might cover the start-up costs of bringing alternative practitioners into their offices: expand the practice’s offerings by adding health workshops and seminars, as the Chopra Center does. "These educational programs can be very cost effective, generating a good amount of income," he says.

A sampling of recent events sponsored by the Chopra Center includes: a weekend health intensive, meditation instruction, book signings, a 3-day workshop for those facing cancer, instructor certification courses, evening group meditations, and a 5-day seminar on emerging trends and theories in mind-body medicine. Two more sources of revenue for the center are its cafe and bookstore, both located on the ground floor of the building, where staff and visitors may enjoy specially-prepared vegetarian cuisine and browse the bookstore.

Role of Research

Dr. Chopra is a keen student of the scientific research supporting mind-body medicine. In 1997 he wrote the forward for Candace Pert’s Molecules of Emotion. When he advocates massage, talking about how rich in hormones and biologically active the skin is, he explains that "when we stimulate the skin, we can cause, literally, a shower of healing chemicals into our blood stream." It is clear that his ideas are formed, in part, by Pert’s research.

For her part, Pert recalls, in her book, meeting Dr. Chopra for the first time at a conference in 1991, how she was struggling, and his telling her, "You are trying too hard." She accepted his invitation to spend a few days at his Lancaster center, where she was treated to a daily massage. In Molecules of Emotion Pert details how these experiences, plus her neurochemistry research, and a host of other events, led her to the realization that our emotions and our biochemistry are part of one continuous information loop that accounts for how we feel and how mind-body medicine works.

Emphasizing the pivotal influence he thinks research will have in bringing about changes, Dr. Chopra says. "As studies come out, from HMOs as well as universities and hospitals, health insurance executives will start to see the wisdom of including more alternative practices. They will."

Rejuvenation is the main reason that guests come to the center. There are usually a total of about 18 people on any given day. Some people think of it as The Pritikin Program for spiritual seekers, except that the Pritikin Center is residential and here you have to stay in a hotel. Behind that, or within that, are detoxification, purification, and immune boosting. The guests on the program often have 2 hours a day blocked out for back-to-back treatments. Such phrases as therapy, pain management, and stress relief are not part of the Center’s vocabulary. The 20 percent of massage clients who buy a¢ la carte treatment use massage, cafe, and bookstore as anyone would a day spa.

Chopra’s Center offers Ayurvedic massage treatments 7 days a week, for the benefit of guests taking the health programs and for people who would like to schedule one of the therapies on an a¢ la carte basis.

The massage therapists on staff come from diverse educational backgrounds and receive 3 weeks of paid on-the-job training before they may work with clients. Dr. Chopra said, "They have to have a good understanding of the theory and practice of Ayurveda." In addition to being trained by Maskell a graduate of Marharishi International University, Dr. Chopra says, "We encourage them all to meditate and I personally do several courses for them about mind-body medicine."

The recruitment of therapists is accomplished by Maskell who was trained in Ayurvedic therapies by a therapist from Dr. Chopra’s Massachusetts center. She shares his background as a student of TM and Ayurveda and she is thoroughly versed in the philosophy and practice of the work. The treatments are focused on working oils into the tissue to bring up the toxins and stimulate the immune system, according to Maskell. The intent of purification from toxins is derived from the original Panchakarma, the "five actions" of Ayurveda which, in ancient times included therapeutic blood-letting and vomiting.

Today, especially in the two-therapist sessions, it can be more "like a dance," according to Thomas Jones, a massage therapist who also has been part of the staff since the center opened. Two therapists massaging a client in a carefully synchronized sequence, is a specialty at Chopra Center. "You have to be totally aware of what the other therapist is doing" during these treatments, Jones says. Clients select from either 35- or 75-minute sessions with either one or two therapists. The treatments are given in silence and emphasize careful attention to such details as keeping the oils heated to the proper temperature.

In choosing staff, Maskell finds that prior hours of training and experience have not been as important as finding "people who will be empathetic and caring in the treatment rooms." Since about 80 percent of the clients are on the 3-or 7-day personalized programs, Maskell knows that a care-giving attitude serves well.

Because as many as half of the treatment sessions involve two therapists working together in closely synchronized four-handed massage, Maskell says, the initial training period can be rather mechanical. On the other hand, the therapists enjoy variety in their work because the sessions vary as the therapist works in different parts of the menu. In addition to signature Panchakarma detoxifying massages, there is full-body massage and a deep-tissue massage plus Ayurvedic wraps, scrubs, and facials.

Five treatment rooms, plus a specially equipped kitchen for therapists to herbalize oils and make other preparations for treatments, are located on the ground floor of the center, down a protected hallway. Out front, with doors and windows opening onto sidewalk and garden, are the reception desk, caf? and bookstore. Farther back on this level is the spacious Dharma room, which accommodates larger gatherings, classes, and public lectures. A warm, informal feeling of a community center prevails, with people exchanging greetings as they come and go.

Dr. Chopra’s design for the interior of his building is a remarkable mixture of Eastern and Western culture, serving-up eyesful of sensory experience for the visitor. Maskell, says that the place feels to her "like a castle." Therapist Jones describes the interior as "high alchemy, fine things for the senses." Any straight lines inside the building seem to have been purposely rounded off, taking away the sense of beginnings and endings. The lighting is indirect and subdued throughout. Everywhere the decor is a blend of East and West, as if the colors and designs of India had been laid over the contemporary design themes of the American Southwest. Also evident is the blend of old world and new, local community and international community, masculine and feminine, indoor with outdoor, and of course, allopathic medicine with alternative medicine.

The physical decor of the Center well reflects Dr. Chopra’s integration of philosophies and modalities. Still, his bright, far-reaching vision is out of time, too uncommon and too ambitious to fit into the world of managed-care that is dominated by insurance companies in the last years of the 20th century. Yet it might well be the prescient model of health care as it will be practiced in the early 21st century, a model that integrates massage therapy into every total treatment plan.

(Visit www.chopra.com to see photos of the center and for on-line shopping in the bookstore.)

Brian Coughlan, NCTMB, a Sonoma, California, AMTA member, is a frequent contributor to Massage Therapy Journal.